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Systems in crisis

2016

Services for Traumatized Young People in Crisis Nationally

Jessica Hadley, CYC & Thom Garfat, PhD

The young people who assaulted the workers at the Selkirk
Behavioural Health Foundation in Manitoba on May 30, 2016 have been
arrested and charged. This is as it should be. Unfortunately, that is
normally as far as our response to such incidents go - but we are
hopeful that this time there may be a difference in how people within
the system respond.

Before we get to that, let us say that this is not just a
Manitoba-specific occurrence. It can be seen as an example of a national
problem in the care and treatment of our most traumatized young people.

Likely, there will be an inquiry and it will highlight a
number of issues or recommendations which will have been identified
before in previous inquiries in other jurisdictions across Canada, such
as:

• Inadequate funding for organisations
providing services to our most vulnerable and traumatized young people,
• Lack of qualifications for direct care staff and a lack of hiring
standards,• Ineffective staff ratios.• A program focus on
conformity and control rather than treatment,• A failure to engage
young people in the process of their treatment,• A lack of
appropriate supportive supervision for staff, and • A failure to
recognize the Child & Youth Care profession and its skill set

We need only to look at the recent Residential Services
Review report in Ontario (CBC News Online May 2016) to understand that
this is a nation-wide crisis; a crisis which blurs the lines between
governmental jurisdictions and portfolios. There are programs and
people in every corner of Canada who are doing good work and genuinely
helping young people and their families. Yet, it is an unfortunate
reality that time and time again (following such incidents) we hear that
the system needs to change. In simple terms reports on such incidents,
across the country, say that the system is just not working well, that
it is a system in crisis.

We cannot continue to react to young people as if their
struggles were only of their own making, expecting them to conform to a
system of demands which treats them as objects, not subjects, and
expects them to comply without responding to their needs as developing
human beings.

With regard to the incident in Manitoba, we are encouraged by
the message that the new Party in power in Manitoba was sending
throughout its campaign, and in their early weeks in office, that they
want to make a difference in the lives of the traumatized, disconnected,
discarded and marginalized Children, Youth, and Families of Manitoba. It
is our sincerest hope that we can work with the government to avoid old
ways of assigning blame, mouthing rhetoric, or quietly shelving inquiry
findings and instead move forward in action to forge a new path, to work
collaboratively towards change. It is also our sincerest hope that this
newly forged partnership can be a rallying point for change not only for
the children and youth of Manitoba, but for the rest of Canada as well.

This is, as we said earlier, not a Manitoba-specific incident
- rather it is a symptom of the need for us to change - nationally – how
we recognize, respond to, and treat traumatized young people and those
who work with them. Why is it that the most damaged of our children
receive the least adequate of services? When do we as a society
recognize that we are not developing whole sections of our most valuable
resource?

It is time for a different response than we have had in the
past. We are hopeful that Manitoba might lead the way.

I am having a reaction to your suggestion that the young people in
Manitoba have been arrested and charged and in particular, as you put
it, 'that is how it should be'. I don't know anything about lions, so if
I go into a cage with a lion and he eats me, it is hardly his fault!

Your mail outlines several reasons why the system in Manitoba is
dysfunctional. In that context, it is not surprising that staff got
assaulted. I am not suggesting that the children are not responsible for
their actions, but criminal convictions do not tend to help children's
overall life situation. It seems a little unfair to me to use
convictions as a punishment when the children's behavior is the
inevitable (and expected) consequence of a dysfunctional system.

Regards.

John Byrne...

As Henry Giroux writes youth are terminally abandoned and socially
excluded. One of the places they are relegated to, in this abandonment,
is the care system which has performed as it always has in a woefully
inadequate manner where both youth and the workers are at risk.

The solution begins with a value proposition which places the well
being of children and youth, especially the most in need and
marginalized , at the centre of our societal care and concern.

When this becomes the reference point for the allocation of resources
and the design of both mainstream and alternative services and responses
then we will start to see the eradication of the indicators of the
opposite proposition.

Central to this paradigm shift is the voice and active presence of
youth in the creation of schools, communities and services that are
truly intended to help them achieve their potential.

Rick Kelly...

Hi Jessica & Thom,

I agree entirely with the heartfelt sentiments you expressed. On the
other hand I'm concerned with the notion that the problems you identify
can be solved by increasing the numbers of highly qualified
professionals. If the 'system' stays the way it is, the number of kids
being diagnosed and treated for specific traumas and disorders will
continue to escalate and the pharmaceutical industry will continue to
flourish. After half a century in the field, I remain convinced that all
our mental and emotional health problems are born in relationships and
can only be resolved through relationships. I'm equally convinced that
Child & Youth Care is the only profession that actually works with young
people as subjects rather than ‘treating’ them as objects. I realize
I’ve said this many times before but ‘dementia’ takes one back to
basics.

Cheers,

Gerry Fewster...

Jessica & Thom,

The complexity of the issues you bring up makes it difficult for me
to express an opinion as multifaceted but here it goes. The research on
trauma and how to effectively help individuals cope is available.
CYC-P's have the opportunity to work with families to educate and
potentially stop cycles of trauma that historically occur in society. As
I learn more I believe early intervention within communities/families is
the approach governments need to support. Group homes and institutions,
for individuals who have been traumatized and are displaying mental
health issues and debilitating coping strategies, is beginning to
feel/look like last resorts with minimal hope of change. The resources
required to assist individuals overcome years of learned behavior and
trauma is not available and CYC-P's do their best. In the end it all
comes down to the mighty dollar. Individuals holding the purse strings
are not making decisions based on best practices. How unfortunate that
we live in a society where individuals have to be beaten/traumatized
before policy makers complete inquiries which often go nowhere. To those
of you working on the floor I thank you but I also ask you to join in
and advocate for change not only for your safety but the well being of
the children and youth of the future.

Be well.

Charlene...

Jessica and Thom,

I admire and respect your willingness to bring these issues into the
public eye – this must happen! Without public awareness of the important
work done by child and youth care staff and agencies to support
societies most vulnerable we will see little change. We need people
lobbying the government and funders for increases in resources that will
allow us to work with highly traumatized and violent youth in a way that
best serves them and keeps everyone safe. We have seen the level of
trauma, violence, mental health, and addiction rise dramatically over
the past decade or so. I had a staff member who was held at gun point a
few years back. This was unheard of 20 years ago in Canadian child
welfare programs. Yet, our programs are still being funded at rates that
support the way it used to be.

I want you to know that I am in full support of calling on our
governments and our citizens to make real change. I believe that it is
high time to educate the masses on what child and youth care is, the
importance of the field in relation to the greater good of society, and
the resources that we need to do it.

Gerry – You speak of how "our mental and emotional health problems
are born in relationships and can only be resolved through
relationships" and I completely agree. However, we cannot get to the
place where child and youth care practitioners can engage in the
relational aspect of their work if they are entering each shift in a
state of overwhelm and fear. Too often staff are working the floor with
6 very high needs youth by themselves with little to no training. They
go through their shift on autopilot just trying to come out unscathed
without any critical incident. I believe we can only do the critical
work of relationship when people feel safe, supported, are trained in
how to be in the relational life space with youth, and have enough
manpower to allow for workers to spend time with youth one to one where
the relationship can be built.

Respectfully,

Michelle Briegel...

Hi everyone,

What an important discussion! While I mostly agree with Gerry, I do
not agree that child and youth care work is the only profession that
works with young people as subjects rather than objects. I have met many
professionals from different training backgrounds that work within a
truly developmental and strengths-based paradigm, and I have also worked
with child care workers using a mainly medical model in their approach.
I agree that child and youth care work has a very unique way of working
with children and youth, but to say that it is the ONLY approach that
matters and that everyone else is getting it wrong? That said, from my
perspective I find myself completely aligned with a child and youth care
way of working, more so than most of my social work colleagues. I also
find that I often have to work hard to explain to even child care
workers why I am not interested in hearing about “disorders” and
“dysfunctions”. Perhaps we can make some allowance that there are
individuals who transcend the traditional professional boundaries and
that the thing that unites them is children? Just my two cents….

Werner van der Westhuizen...

Well, hello again Werner,

Like you, I also know many practitioners from related professions who
create relationships that focus on the subjective experience of their
‘clients’. Working as a “psychologist” and “therapist” I was one of
them. My point is that Child & Youth Care is the only profession that
adopts this as fundamental principle of practice – well, at least, my
version of Child & Youth Care. And this could be the heart of the
matter. Even after so many years of involvement in our ubiquitous field,
I still can’t be sure what principles and practices actually defines our
work. Many moons ago, when we made a shift from The Journal of Child &
Youth Care to Relational Child & Youth Care Practice, it was an attempt
to provide a broad relational context as a framework for professional
practice and development. But, as I see it, the term ‘relationships’ has
become a convenient and meaningless catch-all for any form of
‘intervention’. Everything we do can be termed ‘relational’ one way or
another, whether we’re playing floor hockey or dishing out meds. Unless
we have what it takes to spell out clearly what we mean when we talk
about “relationships,’ we will continue to sail aimlessly on a sea of
ambiguity. If we really want to be recognized as a profession, this will
involve research, and why not? There are CYC programs in countless
colleges and universities across North America. What stops them from
taking an empirical stance to explore the nature of human relationships?
Is it because they would have to create new concepts and theories? Is it
because faculty members are afraid to step beyond the old worn out
methodologies? Or is it because we simply don’t have the courage to
challenge the status quo?

O.K. Werner I’m back on one of my old rants. So, here’s one more for
those who believe that the answer lies in having more and more
professional involved in the lives of children. Back in the 1980s I was
hired to prepare a major report on children’s mental health for the
Government of Alberta. One of my conclusions was, if we had a helping
professional available for every man woman and child in the Province,
the number of mental health ‘cases’ would rise to astronomical
proportions. You can imagine how the various professional groups
responded to this one. The report, “Expanding the Circle,” was all about
relationships, not just between professionals and clients but within
families, schools and communities. The underlying message was that,
while some ‘interventions’ may show favourable short-term outcomes, the
developmental needs of children can only be addressed through
relationships that continue to see each child as a unique, separate,
resourceful and valued human being. Since that time I’ve held onto the
belief that the one profession with the scope and freedom to explore,
practice and promote such relationships was, and is ... well, you know.
Once more onto the breach dear friends, once more.

I’ll take your “two cents” and raise you five.

Cheers,Gerry Fewster...

Quite an interesting discussion here! I see Werner's point, that many
professionals develop therapeutic relationships with young people and
treat them as subjects rather than objects. However, I would have to
agree with Gerry that Child and Youth Care Practice is the only
profession that embodies relational, strength-based practice as a core
therapeutic tool in intervention. Unfortunately, I fear that CYCPs
around the globe are still struggling with defining this approach
clearly.

As a quick experiment, I Googled "what is a child and youth care
practitioner" and "what is a child and youth worker". All results showed
lengthy definitions or college program descriptions that defined us as
providing support to children and youth with varying needs (hmmm,
needs-based approach...is that what we do?). Even the OACYC does not
outline a clear definition of our strength-based and relational model.
As a CYCP I know I can dig and find a relational definition but to the
general public we are no different than Social Workers, therapists, etc.

I think we need to redefine ourselves practically, starting in
Colleges (as Gerry suggests), and start collecting empirical data that a
relational and strength-based approach is effective in creating positive
change. AS CYCPs we also know that the most important change is often
systemic, not individual. If we start advocating for the strengths of
youth rather than focusing on their maladaptive behaviours, I believe we
can affect some of that systemic change. In the process, through
supporting positive relationships, youth will initiate their own
positive individual change (if that is what is needed).

Perhaps this is a good reflection in the Manitoba case? Can we start
advocating as a profession and prove to governments that CYCPs have a
unique skill set to help reduce the problematic issues faced by
treatment programs, health care programs, residential programs, school
boards, etc., etc...

Nancy Marshall…

Working in the desert of youth caring
professionals in Minnesota I find this discussion interestingly
frustrating. I work in an RTC that is stuck in behavioralism and command
and control approaches to youth counseling. No learning theory. No life
space intervention. Just adults telling kids how its gonna be and then
helping them to adjust to that adult defined reality. And the youth
counselors are increasingly upset because the kids continue to do battle
with the adults. Youth counselors are underpaid, poorly trained and
burnt out. Creativity is stymied out of staff fears. And administration
doesn’t have a vision.

I’m an all-but credentialed mental health professional who can’t fit
into the system because I’m unwilling to work fulltime for self care
(family care) reasons. Youth counselors are paid low wages and expected
to put up with everything. Some staff overspend money to buy kids happy
moments while others hide behind cell phones while kids do their own
thing.

Kids languish in RTC/shelters for years while their high paid social
workers wonder what to do with the child who reads like a monster on
paper. How many mental health practitioners or child protection
servicers does it take to fix a child? I’ve been in meetings in homes of
families living in abject poverty while five well paid professionals sit
around and discuss the plan for helping the family get better.

The system in America, or at least Minnesota, is broken. Ivan Illich,
John Mcknight and Mark Courtney all named it as industrialization and
capitalism. As our professional schools churn out debt laden social
workers and youth workers and mental health workers the professionalism
codifies helping as a career to be bought and sold. As we build more
well paid desk jockey professionals we get less sustenance for nurturing
supports for families in crisis. Child protection is a farce. The
system will change from crisis to health when we stop the mechanisms of
industry from commodifying childrens bodies as a site of professional
protection and start supporting families to maintain and nurture their
own integrity. Social work has lost its way. There is no ethical
practice. It’s all a lie we tell ourselves to justify our wages.

Yes, we can have real relationships with children in care. But if
those relationships do not need the child back under the nurturance of
belonging in a family then they aren’t subjective but objective. Youth
caring has to lead back to family. The smallest unit of individualism
has to be family otherwise we are commodifying dependency.

The system is beyond crisis. It’s Armageddon.

Peter DeLong.USA ...

I heard Larry Brendtro tell this story years ago about the many
“professions” who work with youth.

Seems that a new program was beginning, and there was a once a week
training plan in place for the Child & Youth Care Workers.

Week One: Nurse lectured about First Aid and safety concerns with
teens.Week Two: Social Worker lectured about importance of Family
and Community.Week Three: Psychologist lectured about IQ, Mental
Illness & Mental Health.Week Four: Dietician lectured about the
importance of good nutrition. Week Five: Distinguished Educator
lectured about the value of learning for self-esteem.Week Six:
Recreational Therapist lectured about the benefits of a healthy body.
Week Seven: Psychiatrist lectured about psychotropic medications in
treatment.

In Week Eight, all the experts were reassembled for a panel to answer
questions from the Child & Youth Care Workers, who by this time had
several weeks experience with the teens.

The first question came from a CYCW from the back, “What do you do
when you’re driving the van full of kids, and one boy in the back keeps
giving the finger to every trucker that passes?”

From the panel - SILENCE. There you have it, the training failed to
have a Professional Child & Youth Care Worker!

Charlie Baker...

Charlie,

I love your example here! I may quote you in future. Thank you for
that anecdote!!

Nancy…

Hi Everyone,

I love this discussion and the points that have been brought forward
as these speak to the passion we have for our field. I think it is fair
to say, the issue of being recognized as a valued profession with the
unique skill sets in engaging with vulnerable youth and families has
been an ongoing source of contention for many years. The truth of the
matter is that until we have become a regulatory body recognized by
other disciples, similar discussions will continue. We will likely
continue to be referred as “others” or in some situations (as I speak
from experience) be criticized for having inappropriate alliances with
families as we demonstrate a relational, strength based approach in our
practice.

So my question is do we continue our rant, as rich as it has been or
are we prepared to make the steps to advocate for our profession by
educating other and challenging those who deem our profession as
“others” and indiscriminate?

So where do we start??? To follow Nancy’s point, create a universal
term that defines our role and profession that is shared across the
board, colleges, universities, schools, and all agencies and
organizations that service children and families. Become regulated and
perhaps then will shifts occur in others views of who we are and what we
do. Perhaps then will CYCs in the school board be assigned the role as
CYC as opposed to BTA; perhaps high schools will recognize the
importance of having two CYCPs in a school of 500+ students as opposed
to being the one solo CYCP responsible for managing the emotional needs
of all. Perhaps we will be referred to as Child and Youth Counselors
will be acknowledged in the same discussion as Social Workers,
Psychiatrists as opposed to others.

Donicka
_____

THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK (CYC-Net)
Registered Non-Profit and Public Benefit Organisation in the
Republic of South
Africa (031-323-NPO, PBO 930015296)